LAWRENCE — Kathleen Christian is a remarkably healthy 63-year-old. She has no chronic conditions and rarely sees the doctor for anything other than preventive care.

Even so, she said she had been looking forward to getting health insurance under the Affordable Care Act, after having been without coverage since she was laid off in 2009.

But last month, Christian learned she would not be able to get coverage after all.

Because Kansas has not expanded Medicaid eligibility under the ACA, she is one of an estimated 85,000 Kansans who experts predict will fall into the so-called "Medicaid coverage gap."

Christian is not eligible for Medicaid (also known as KanCare in Kansas) because she earns too much to qualify for it but she is too poor to qualify for the ACA’s federal tax credits to buy private insurance.

Without the subsidies, there is simply no way she could afford $384 each month for the cheapest plan on HealthCare.gov, Christian said.

"Where am I supposed to get $384 every month? I budget and keep a spreadsheet. I know where every penny goes," Christian said.

Her 2012 adjusted gross income from part-time work was $5,008 and her monthly Social Security checks are about $800, she said.

"The last day of (November), I had $2.96 to my name. By the grace of God, every time I run out, usually the next day I have something to work with," she said. "I'm not alone. I know lots of people like me, lots of people who are struggling. There's just no way they can pay these premiums. It's just not realistic."

Christian said she lays equal blame on President Obama and Gov. Sam Brownback, who has opposed provisions of the ACA from the beginning.

"They're just a bunch of boys having an argument about who's better than who. It's all a political game for them. I don't think they're really seeing what they're doing to people," Christian said. "I guess people who have money just don't understand what being poor is. I'm not materialistically poor — I have a roof over my head, thank God, and we have enough food, although we could use a little bit more. We're not starving to death. But we're cash poor. That's just the way it is."

Christian said when she found out she'd be in the coverage gap, she wrote a letter to Brownback expressing her frustration:

She was laid off from her long-time job at a Lawrence home security company during the recession, she said.

Apart from a minimum wage job capped at 18 hours a week and the occasional temp job, she’s been out of work for four years.

"I'm in my sixties. It's not real easy to get a job," Christian said.

She has custody of her 13-year-old grandson and gets $115 per month in food stamps.

"It was $135, until they cut it back," she said.

When push came to shove, she filed for early retirement to get the Social Security payments, a move that means she gets lower monthly payments than if she had waited longer to take retirement.

"It was the only way I could support us. I didn't want to do early retirement, but I had no choice," she said.

Her grandson is covered by KanCare, which has less restrictive income requirements for children and pregnant women, but she has no health insurance. She pays for her dental cleanings every six months out of pocket.

"At this point, I'm just biding my time until I can get Medicare," she said.

Christian said she wrote to Brownback hoping a personal story might "get through to him."

“I told him that, as far as I'm concerned, the state of Kansas should be paying the premium credits for those people who do not qualify. I told him that maybe $384 is chump change to him and his people, but it's a lot of money for me,” she said.

Brownback spokesperson Sara Belfry acknowledged receipt of Christian’s letter.

“We did receive a letter from Kathleen (and), like all other correspondence we receive from constituents, we sent a response,” Belfry wrote in an email. “Beyond that, I have no further comment.”

Christian said she has yet to receive a response.

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→ Single mom in KCMO seeks benefit of preventive care
→ KS Senate president says Medicaid expansion unlikely to gain approval this session